Drugs, sexual impulsivity, HIV: Psychosocial and cognitive risk factors of YMSM

描述（由申请人提供）：男性之间无保护的性行为占所有报告的艾滋病病例的58%和艾滋病毒病例的80% 1,2。15至24岁青少年的艾滋病毒感染率继续上升，男男性行为仍然是青少年男性感染艾滋病毒的主要原因1,2。超过90%的YMSM报告在过去6个月内有不止一名性伴侣，33%到49%的人在同一时间有过无保护的肛交3。研究表明，使用兴奋剂，特别是甲基苯丙胺，可能影响危险的性行为，并助长最近的艾滋病毒和其他性传播感染浪潮4-6。理论的系统发展已被确定为有效干预发展的关键步骤，但以前的概念模型侧重于相对有限的解释性结构。然而，社会行动理论（SAT）7为检查YMSM的风险行为提供了一个有希望的模型，因为它包括个人以及社会和环境决定因素。SAT在艾滋病毒和YMSM领域的应用仍有待检验，因为该模式最初是作为成人人口的一般健康促进模式设想的。使用Kipke博士的NIDA资助的“健康青年男性研究”（HYM）的数据，本研究将进行多变量分析，以测试该模型在YMSM人群中的应用。本研究的具体目的是：1)实证验证社会行动理论中描述的关系链，以确定该理论是否解决了性行为和药物冒险行为与YMSM相关的个人、环境和社会相关因素的相互作用；2)通过测试和整合其他行为理论模型中描述的相互竞争的理论关系，进一步验证SAT，以建立一个综合的社会、心理社会和认知风险因素理论，以指导YMSM中吸毒、性冲动和艾滋病毒的预防干预工作。这项研究将有助于实现艾滋病科学研究转型跟踪奖的目标：1)支持一名新研究人员；2)解决NIDA在艾滋病毒、药物滥用、冲动和高危人群应对策略方面的研究目标；3)通过完善综合理论模型，我们将为制定干预措施提供一个平台，以解决与艾滋病毒传播相关的风险行为。公共卫生相关性：本研究将通过建立一个模型来了解环境风险因素、冲动和应对策略如何汇聚到药物滥用和性冒险行为中，从而有助于对高危青少年进行有效的艾滋病毒干预。

DESCRIPTION (provided by applicant): Unprotected sexual intercourse between men constitutes 58% of all reported cases of AIDS and 80% of HIV cases 1,2. Rates of HIV infection among 15 to 24 year olds continue to increase with MSM behavior remaining the leading cause of HIV infection among adolescent males 1,2. Over 90% of YMSM have reported having more than one sexual partner in the past 6 months and between 33% and 49% have had unprotected anal intercourse during the same time3. Studies show that use of stimulants, particularly methamphetamine, may influence risky sexual practices and contribute to the most recent wave of HIV and other sexually transmitted infections (STIs)4-6. Systematic development of theory has been identified as a crucial step in efficacious intervention development, but previous conceptual models have focused on a relatively limited array of explanatory constructs. However, Social Action Theory (SAT)7 provides a promising model for examining the risk behavior of YMSM, because it includes individual as well as social and contextual determinants. SAT remains to be tested for use in the field of HIV and with YMSM, because this model was originally conceived as a general health promotion model for the adult population. Using data from the Dr. Kipke's NIDA funded "Healthy Young Men Study" (HYM), this study will conduct multivariate analysis to test this model for use with the YMSM population. The specific aims of this study are to: 1) To empirically validate the chain of relationships depicted in Social Action Theory to determine if the theory addresses the interaction of individual, contextual, and social correlates of sexual and drug risk taking behaviors as they relate to YMSM; and 2) To further validate SAT by testing and incorporating competing theoretical relationships depicted in other behavioral theory models to develop a comprehensive theory of the social, psychosocial and cognitive risk factors for drug use, sexual impulsivity, and HIV among YMSM to guide prevention intervention efforts. . This study will contribute to the objectives of the AIDS-Science Track Award for Research Transition by 1) supporting a New Researcher; 2) addressing the NIDA research objective in the area of HIV, drug abuse, impulsivity, and coping strategies of an at-risk, under represented population; and 3) through refinement of a comprehensive theoretical model, we will provide a platform for developing interventions that address risk behavior related to HIV transmission among YMSM. PUBLIC HEALTH RELEVANCE: This study will contribute to effective HIV interventions for at-risk youth by developing a model to understand how environmental risk factors, impulsivity, and coping strategies converge into drug abuse and sexual risk taking.